Suicide ideation versus suicide attempt: Examining overlapping and differential determinants in a large cohort of patients with depression and/or anxiety

2020 ◽  
pp. 000486742095125
Author(s):  
Jasper XM Wiebenga ◽  
Merijn Eikelenboom ◽  
Henriette D Heering ◽  
Patricia van Oppen ◽  
Brenda WJH Penninx
Keyword(s):  
Anxiety Disorder ◽  
Suicide Attempt ◽  
Childhood Trauma ◽  
Suicide Ideation ◽  
Age Of Onset ◽  
Depression And Anxiety ◽  
Psychosocial Characteristics ◽  
Younger Age ◽  
Lower Education ◽  
Suicidal Patients

Objective: Individuals with a depressive and/or anxiety disorder are known to have an elevated risk of suicide. However, these diagnoses alone are insufficient at differentiating patients with suicide ideation that attempt suicide from those that do not. Few studies examined such differences in an ideation-to-action framework. Using this framework, extensive multivariate testing was performed to examine differences between suicidal patients with and without a suicide attempt. Method: Data were from 1576 respondents with a depressive and/or anxiety disorder, participating in the Netherlands Study of Depression and Anxiety. Logistic regression analyses were used to analyze associations between sociodemographic, clinical, personality, and psychosocial risk factors and suicide ideation and attempt. Results: Patients with suicide ideation could be uniquely distinguished from non-suicidal patients by more years of education, presence of a depressive disorder (vs anxiety disorder) and higher introversion. Patients with suicide ideation and a past suicide attempt could be uniquely distinguished from non-suicidal patients by a younger age of onset, a lifetime alcohol use disorder, more external locus of control and lower levels of social support. Within the group of patients with suicide ideation, patients with a suicide attempt were more likely to have childhood trauma and lower education, and be of non-Western descent than patients with suicide ideation and no past attempt. Conclusion: This study found that although various clinical, personality and psychosocial characteristics distinguish patients with suicide ideation from non-suicidal patients, many of these often-cited factors do not distinguish patients with a suicide attempt from those who only think about suicide. However, childhood trauma, lower education and non-Western descent could aid in detecting suicide attempt risk among patients with suicide ideation.

Suicide and Aggression

1967 ◽  
Vol 21 (3) ◽  
pp. 745-751 ◽  
Author(s):  
Sherman Eisenthal
Keyword(s):  
Suicide Attempt ◽  
Repeated Measures ◽  
Suicide Ideation ◽  
Psychiatric Patients ◽  
Significant Degree ◽  
Viewing Time ◽  
Control Groups ◽  
Content Analyses ◽  
Suicidal Patients

Suicide-attempt, suicide-ideation, and non-suicidal control groups of VA neuro-psychiatric patients were divided into psychotic and neurotic subgroups ( ns = 15). Ss viewed two classes of slides, a series of death scenes and one of unpleasant scenes. Each series contained both aggressive and non-aggressive content. Analyses of this 3 × 2 × 2 factorial design, with repeated measures, were based on measures of viewing time, rated tension, and rated liking. Aggressive slides induced greater threat than non-aggressive slides to a significant degree in the death slide series and to a lesser degree in the unpleasant slide series. Suicidal patients did not manifest a consistent style of response to aggressive slides in either series. The measure of aggressive mood also was not different for suicidal and non-suicidal patients. Suicide ideators did not differentiate aggressive and non-aggressive slides but attempters and controls did. The role of anxiety level was discussed.

scholarly journals A literature review to investigate the link between psychosocial characteristics and treatment adherence in cancer patients

2012 ◽  
Vol 6 (1) ◽  
pp. 5 ◽  
Author(s):  
Paraskevi Theofilou ◽  
Helen Panagiotaki
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Treatment Adherence ◽  
Observational Studies ◽  
Search Strategy ◽  
Depression And Anxiety ◽  
Psychosocial Characteristics ◽  
Adherence To Medication ◽  
Younger Age ◽  
Positive Effect

Adherence to medication has been recognized as a key issue in health outcomes and efforts to improve patients’ adherence are being made by the pharmaceutical industry, experts, and government bodies alike. This paper presents a review of these issues according to previous descriptive findings. Relevant studies written in English, published in 1976 or later, were identified through Medline, Embase and PsycInfo databases and reviewed. Review articles and clinical trials were excluded; all observational studies and surveys were considered. Articles were reviewed for any discussion of patients’ characteristics and psychosocial characteristics affecting <em>adherence</em> to <em>cancer</em> treatment. The search strategy included a combination of key words adherence and cancer in titles. The major findings are summarized and presented under two main headings: i) patients’ characteristics; and ii) psychosocial characteristics. In general, factors associated with increased likelihood of adherence to cancer treatment included younger age, higher education, higher income and Caucasian ethnicity. With regards to the psychosocial factors, lower levels of depression and anxiety, optimism as well as social support seemed to have a positive effect on treatment adherence. Studies of patterns of care in cancer treatment can help identify challenges in health care provided to particular subgroups of cancer patients and can aid researchers in designing studies that account for such factors in clinical and outcomes’ research.

scholarly journals Anxiety and anxious-depression in Parkinson's disease over a 4-year period: a latent transition analysis

2015 ◽  
Vol 46 (3) ◽  
pp. 657-667 ◽  
Author(s):  
S. Landau ◽  
V. Harris ◽  
D. J. Burn ◽  
J. V. Hindle ◽  
C. S. Hurt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Age Of Onset ◽  
Latent Transition Analysis ◽  
Depression And Anxiety ◽  
Transition Analysis ◽  
Anxious Depression ◽  
Younger Age ◽  
Latent Transition ◽  
Severe Anxiety

BackgroundDepression and anxiety in Parkinson's disease are common and frequently co-morbid, with significant impact on health outcome. Nevertheless, management is complex and often suboptimal. The existence of clinical subtypes would support stratified approaches in both research and treatment.MethodFive hundred and thirteen patients with Parkinson's disease were assessed annually for up to 4 years. Latent transition analysis (LTA) was used to identify classes that may conform to clinically meaningful subgroups, transitions between those classes over time, and baseline clinical and demographic features that predict common trajectories.ResultsIn total, 64.1% of the sample remained in the study at year 4. LTA identified four classes, a ‘Psychologically healthy’ class (approximately 50%), and three classes associated with psychological distress: one with moderate anxiety alone (approximately 20%), and two with moderate levels of depression plus moderate or severe anxiety. Class membership tended to be stable across years, with only about 15% of individuals transitioning between the healthy class and one of the distress classes. Stable distress was predicted by higher baseline depression and psychiatric history and younger age of onset of Parkinson's disease. Those with younger age of onset were also more likely to become distressed over the course of the study.ConclusionsPsychopathology was characterized by relatively stable anxiety or anxious-depression over the 4-year period. Anxiety, with or without depression, appears to be the prominent psychopathological phenotype in Parkinson's disease suggesting a pressing need to understanding its mechanisms and improve management.

scholarly journals Effects of Childhood Trauma, Daily Stress and Emotions on Daily Cortisol Levels in Individuals Vulnerable to Suicide

2019 ◽  
Author(s):  
Daryl Brian O'Connor ◽  
Dawn Branley-Bell ◽  
Jessica Green ◽  
Eamonn Ferguson ◽  
Ronan O' Carroll ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Childhood Trauma ◽  
Hpa Axis ◽  
Suicide Ideation ◽  
Control Group ◽  
Daily Stressors ◽  
Daily Stress ◽  
Hypothalamic Pituitary Adrenal ◽  
Cortisol Levels

Objectives: Suicide is a leading cause of mortality worldwide. Dysregulated hypothalamic-pituitary-adrenal axis activity, as measured by cortisol levels, has been identified as one potential risk factor. Evidence has indicated that childhood trauma is associated with dysregulated cortisol reactivity to stress in adulthood. The current study investigated for the first time whether childhood trauma and daily stressors and emotions were associated with diurnal cortisol levels over a 7-day study in individuals vulnerable to suicide. Methods: 142 participants were categorized according to their suicidal history into three groups: suicide attempt, suicidal ideation or control group. Participants completed questionnaires before commencing a 7-day study. Cortisol samples were provided immediately upon waking, at 15 mins, 30 mins, 45 mins, 3 hours, 6 hours, 9 hours and 12 hours on 7 consecutive days. Measures of daily stressors, mood, defeat and entrapment were completed at the end of each day. Results: Participants in the suicide attempt and ideation groups released significantly lower cortisol upon awakening (CAR) and had a tendency towards flatter wake-peak to 12 hour (WP-12) cortisol slopes compared to controls. Childhood trauma was found to be associated with significantly lower CAR and a tendency towards flatter WP-12 cortisol slope. Childhood trauma also had an indirect effect on suicide vulnerability group membership via lower daily CAR levels. Lower CAR was associated with increased suicide ideation at 1-month but not 6-months. Daily stress and emotion measures were not associated with cortisol levels. Conclusions: This is the first 7-day daily diary investigation of naturally fluctuating cortisol levels in individuals vulnerable to suicide. The results indicate that dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity is associated with suicidal ideation and behavior. Childhood trauma appears to be an important distal factor associated with HPA-axis dysregulation.

scholarly journals Familial risk for depressive and anxiety disorders: associations with genetic, clinical, and psychosocial vulnerabilities

2020 ◽  
pp. 1-11
Author(s):  
Eleonore D. van Sprang ◽  
Dominique F. Maciejewski ◽  
Yuri Milaneschi ◽  
Bernet M. Elzinga ◽  
Aartjan T. F. Beekman ◽  
...  
Keyword(s):  
Major Depression ◽  
Childhood Trauma ◽  
Age Of Onset ◽  
Familial Risk ◽  
Severe Depression ◽  
Polygenic Risk Score ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Prevalence Of Depression ◽  
Risk For Depression

Abstract Background In research and clinical practice, familial risk for depression and anxiety is often constructed as a simple Yes/No dichotomous family history (FH) indicator. However, this measure may not fully capture the liability to these conditions. This study investigated whether a continuous familial loading score (FLS), incorporating family- and disorder-specific characteristics (e.g. family size, prevalence of depression/anxiety), (i) is associated with a polygenic risk score (PRS) for major depression and with clinical/psychosocial vulnerabilities and (ii) still captures variation in clinical/psychosocial vulnerabilities after information on FH has been taken into account. Methods Data came from 1425 participants with lifetime depression and/or anxiety from the Netherlands Study of Depression and Anxiety. The Family Tree Inventory was used to determine FLS/FH indicators for depression and/or anxiety. Results Persons with higher FLS had higher PRS for major depression, more severe depression and anxiety symptoms, higher disease burden, younger age of onset, and more neuroticism, rumination, and childhood trauma. Among these variables, FH was not associated with PRS, severity of symptoms, and neuroticism. After regression out the effect of FH from the FLS, the resulting residualized measure of FLS was still associated with severity of symptoms of depression and anxiety, rumination, and childhood trauma. Conclusions Familial risk for depression and anxiety deserves clinical attention due to its associated genetic vulnerability and more unfavorable disease profile, and seems to be better captured by a continuous score that incorporates family- and disorder-specific characteristics than by a dichotomous FH measure.

Clinical Course and Clinical Features in MDD Patients: General and Specific Role of Subtypes of Childhood Trauma: 重性抑郁障碍患者的临床病程及特征：一般及特定童年创伤亚型的作用

2021 ◽  
pp. 001100002199593
Author(s):  
Xianbin Li ◽  
Tony Xing Tan ◽  
Qijing Bo ◽  
Zhen Mao ◽  
Feng Li ◽  
...  
Keyword(s):  
Physical Abuse ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Age Of Onset ◽  
Linear Modeling ◽  
Childhood Trauma Questionnaire ◽  
Diagnostic And Statistical Manual ◽  
Clinical Presentations ◽  
Younger Age

Our study focused on childhood emotional neglect and several forms of abuse (i.e., physical, sexual, and emotional) and the diagnosis and clinical courses of disease in Chinese adults with major depressive disorder (MDD), including MDD with anxiety, with suicidality, and with other presentations. MDD and other clinical presentations were determined with the American Psychiatric Association’s (2000) Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) and subtypes of trauma were assessed with the Childhood Trauma Questionnaire (95 patients and 94 comparisons). Patients with MDD and suicidality scored higher on childhood emotional abuse and neglect than other MDD patients. Both emotional abuse and physical abuse correlated with a younger age of onset and more relapses of MDD. General linear modeling also showed that controlling for demographic variables, emotional and physical abuse predicted more MDD relapses. Overall, childhood trauma was correlated with a MDD diagnosis, the role of specific types of trauma in the clinical courses of MDD varied.

scholarly journals A literature review to investigate the link between psychosocial characteristics and treatment adherence in cancer patients

2012 ◽  
pp. e5
Author(s):  
Paraskevi Theofilou ◽  
Helen Panagiotaki
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Treatment Adherence ◽  
Observational Studies ◽  
Search Strategy ◽  
Depression And Anxiety ◽  
Psychosocial Characteristics ◽  
Adherence To Medication ◽  
Younger Age ◽  
Positive Effect

Adherence to medication has been recognized as a key issue in health outcomes and efforts to improve patients’ adherence are being made by the pharmaceutical industry, experts, and government bodies alike. This paper presents a review of these issues according to previous descriptive findings. Relevant studies written in English, published in 1976 or later, were identified through Medline, Embase and PsycInfo databases and reviewed. Review articles and clinical trials were excluded; all observational studies and surveys were considered. Articles were reviewed for any discussion of patients’ characteristics and psychosocial characteristics affecting adherence to cancer treatment. The search strategy included a combination of key words adherence and cancer in titles. The major findings are summarized and presented under two main headings: i) patients’ characteristics; and ii) psychosocial characteristics. In general, factors associated with increased likelihood of adherence to cancer treatment included younger age, higher education, higher income and Caucasian ethnicity. With regards to the psychosocial factors, lower levels of depression and anxiety, optimism as well as social support seemed to have a positive effect on treatment adherence. Studies of patterns of care in cancer treatment can help identify challenges in health care provided to particular subgroups of cancer patients and can aid researchers in designing studies that account for such factors in clinical and outcomes’ research.

Depression and Anxiety Predict Healthcare Workers’ Understanding of and Willingness to Help Suicide Attempt Patients

2021 ◽  
pp. 003022282110217
Author(s):  
Ching Sin Siau ◽  
Caryn Mei Hsien Chan ◽  
Lei Hum Wee ◽  
Suzaily Wahab ◽  
Uma Visvalingam ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicide Prevention ◽  
Self Efficacy ◽  
Healthcare Workers ◽  
Hospital Setting ◽  
Personal Accomplishment ◽  
Depression And Anxiety ◽  
Willingness To Help ◽  
Psychiatric Department ◽  
Suicidal Patients

We examined whether burnout, depression, anxiety, stress, lifetime suicidal ideation, self-efficacy in preventing suicide and demographic factors predicted the understanding of and willingness to help suicidal patients among hospital healthcare workers. A total of 368 healthcare workers from the major surgical and medical departments in a general hospital setting were recruited. Participants responded to the Depression Anxiety and Stress Scale-21, Self-efficacy in Suicide Prevention, and Understanding Suicide Attempt Patient Scale. Those from the psychiatric department, with higher suicide prevention self-efficacy, and lower personal accomplishment indicated more understanding and helpful attitudes; doctors, depressed and anxious healthcare workers reported less understanding and helpful attitudes. Suicide prevention efforts must be conducted in tandem with equipping and supporting the healthcare workers who manage suicidal patients.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

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